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Diffuse alveolar hemorrhage in a patient with acute poststreptococcal glomerulonephritis caused by impetigo

Masahiro Yoshida1, Hideaki Yamakawa, Masami Yabe

  • 1Department of Internal Medicine, Division of Respiratory Medicine, Jikei University School of Medicine, Kashiwa Hospital, Japan.

Internal Medicine (Tokyo, Japan)
|April 17, 2015
PubMed

Insights

This case study highlights a 17-year-old boy with pulmonary renal syndrome. High-dose methylprednisolone rapidly resolved respiratory failure caused by diffuse alveolar hemorrhage linked to poststreptococcal glomerulonephritis.

Area of Science:

  • Nephrology
  • Pulmonology
  • Pediatrics

Background:

  • Pulmonary renal syndrome is a severe condition affecting both lungs and kidneys.
  • Acute poststreptococcal glomerulonephritis (APSGN) can rarely manifest with diffuse alveolar hemorrhage (DAH).

Observation:

  • A 17-year-old boy presented with hemoptysis and respiratory distress.
  • Bronchoscopy confirmed diffuse alveolar hemorrhage (DAH).
  • Impetigo infection was identified as the likely preceding event.

Findings:

  • The patient was diagnosed with APSGN based on clinical presentation, Streptococcus pyogenes detection, and renal biopsy.
  • High-dose methylprednisolone therapy led to immediate improvement in respiratory failure.
  • The case illustrates a rare presentation of APSGN with DAH.

Implications:

  • This case underscores the importance of considering APSGN in pediatric patients with unexplained DAH.
  • Prompt diagnosis and aggressive treatment with corticosteroids may be crucial for managing respiratory complications.
  • Highlights the effectiveness of methylprednisolone in reversing acute respiratory failure in this context.

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